Provider Demographics
NPI:1215617204
Name:SHUNK, CHRISTOPHER BLAIR (LPC-MHSP)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BLAIR
Last Name:SHUNK
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 VANGUARD DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2862
Mailing Address - Country:US
Mailing Address - Phone:615-574-1420
Mailing Address - Fax:
Practice Address - Street 1:5226 MAIN ST
Practice Address - Street 2:SUITE D1
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-4210
Practice Address - Country:US
Practice Address - Phone:615-574-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional